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I am pregnant
Miscarriage
A miscarriage is a profound and often painful experience. It can come as a shock, stir up feelings of uncertainty, or raise questions about exactly what is happening within your body. You might feel sad, angry, confused, or perhaps completely empty—emotions that can also shift rapidly. Whatever you are feeling, please know that this is entirely normal and that you do not have to go through it alone.
Many women experience a miscarriage at some point in their lives, yet it is rarely discussed. As a result, you may feel as though you are the only one going through this. At 040verloskunde, we understand how deep and life-altering this period can be. We take the time to listen to you, answer your questions, and provide support tailored to you and your specific situation.
Here, you will find clear information about what a miscarriage entails, what the process may look like, and the options available to you. Just as importantly, we are here for you 24/7. You can turn to us with all your emotions, uncertainties, and practical questions—taking it one step at a time, at your own pace.
What is a miscarriage?
A miscarriage is the loss of an early pregnancy, up to 20 weeks gestational age. Usually growth has already stopped in the first 12 weeks.
You can notice a miscarriage by vaginal bleeding (often in combination with menstrual-like abdominal pain or back pain), but often the ultrasound first shows that there is no longer a beating heart before you experience symptoms such as blood loss. And so then you may also have noticed nothing at all. If you have some blood loss, call the midwife. She will discuss with you whether an ultrasound is necessary. We call this a blood loss ultrasound. The ultrasound may show a good pregnancy, but it may also show only an empty amniotic sac without the foetus. The growth of the embryo has then stopped very early in the pregnancy. The ultrasound may also show an embryo, but without a beating heart. The growth of the fetus and the heartbeat have stopped.
How does a miscarriage occur?
Miscarriage is common, with 1 in 4 women experiencing a miscarriage in her lifetime. The cause of a miscarriage is almost always a disposition disorder of the fetus, created during the first divisions after the egg is fertilized. In most cases, a birth defect is a chromosomal aberration in the foetus, which prevents its (healthy) growth. Your body will recognize this, and then reject the pregnancy. A miscarriage is not caused by stress, sex or exercise.
Can a miscarriage be stopped?
A miscarriage cannot be prevented or stopped. If the embryo has not developed properly, it stops growing and is expelled by the uterus. In such cases, a miscarriage cannot be stopped—neither with medication nor with bed rest. A miscarriage is not caused by stress, physical exertion, working, exercising, or sexual activity. You might think that there was something you could have done—or avoided doing—to prevent the miscarriage. While such feelings are understandable, any sense of guilt is misplaced.
What happens during a miscarriage?
If a miscarriage begins spontaneously, you will notice it through blood loss and/or pain. Below, we describe the typical progression; however, please note that the experience can vary from woman to woman.
Blood loss
This can range from bright red to dark red and typically lasts for 5–10 days. The heaviest bleeding usually occurs during the first 1–3 days—you might soak through a sanitary pad every 2 hours. In the days that follow, the amount of blood loss is generally similar to that of a regular menstrual period. You may also pass blood clots, which can be small (like a marble) or larger (like a walnut). It is also possible to pass the gestational sac, which contains the embryo and the yolk sac. Once the gestational sac has been passed, both the bleeding and the pain will typically decrease. If you are concerned about the amount of blood loss, please call us (refer to our contact instructions).
Abdominal pain
You may experience uterine cramps, which feel similar to menstrual pain. The pain can be more intense than what you are used to during your period, and some women even describe it as feeling like labor contractions. The level of pain varies from person to person. Tip: See the section below for more information on pain relief.
Feeling unwell
Many women feel tired while going through a miscarriage. Make sure to get plenty of rest, eat well, and ensure that someone is nearby or with you to provide support. Experiencing a miscarriage can be physically demanding. If you are ever unsure whether what you are experiencing is normal, please do not hesitate to call us.
When do you call the midwife?
Call us day or night at 040-2419841:
- If you are concerned.
- Heavy bleeding: When you have a full pad every half hour, or when you notice that the bleeding is so heavy that it looks like a tap is open.
- If symptoms of pain and blood loss persist for more than a week or do not subside.
- Extreme, excruciating pain, despite pain medication.
- Not feeling well/dizzy/fainting.
- Fever: Temperature above 37.5 (measured rectally).
- If you have doubts about the course of the miscarriage and want to consult.
You are pregnant and the ultrasound shows you are miscarrying, now what?
Now that the ultrasound has seen you miscarry, and after the news has landed, you can decide several things. You can choose to:
To wait, until the miscarriage comes on its own. This is the most natural way. In 37% of women, this happens in the week after the miscarriage is established. The advantage of waiting is that it is the most natural way, and waiting does not affect any subsequent pregnancy. For not everyone, wait-and-see is the best choice; for some women, wait-and-see can be emotionally demanding. If you choose to wait and see, you may still make a different choice at any time. We know that in 30% of women who choose to wait and see, medication or surgery is still needed later.
Take medication. For this you will be referred to the gynecologist, he or she can prescribe medication so that the miscarriage will be induced. This means that you will be given two types of medication, which you will take scattered. First you will take one tablet (Mifegyne) orally, then 1-2 days later you will take 4 tablets (misoprostol) yourself at home vaginally. The miscarriage then takes place at home. After 2 weeks, you will have an ultrasound to check if the miscarriage was complete and your uterus is empty. The disadvantage of the medication is that you often have more pain symptoms than if the miscarriage starts on its own. Other disadvantages are side effects, such as: nausea, vomiting, diarrhea, fever. Furthermore, sometimes the medication does not work (immediately), so it may be necessary to take all the medication a second time. In 1 in 5 women, the medication did not help enough, and there is still a miscarriage residue in the uterus. Then a hysteroscopy (keyhole examination, in which water is introduced into the uterus) or curettage (procedure, under anesthesia, in which the uterine cavity is emptied) may be advised.
Do a curettage. This is an operation under anesthesia. The surgery involves sucking out the miscarriage tissue, through a tube. The surgery itself takes 10-15 minutes. You will be in the hospital for about half a day. After the miscarriage has been diagnosed, surgery can usually be scheduled 1-2 weeks later. In 97-99 out of 100 women, the surgery succeeds. The curettage option is usually not recommended because it may affect a future pregnancy. Therefore, it is good to consider the other options first.
Which option suits me?
The choice is a matter of personal preference. All approaches have advantages and disadvantages. We will help you with all explanations, we will also give you these on paper. You decide what suits you best. Also, an in-between solution is always possible, such as waiting a while and if it takes too long, medication or curettage.
Personalized counseling for miscarriage
Going through a miscarriage is a sad, intense and intense event and is often very exciting. We are happy to help you through this and will guide you intensively. The midwife will stay in touch with you even after the miscarriage if you feel the need.
A miscarriage is the loss of an early pregnancy, up to 20 weeks gestational age. Usually growth has already stopped in the first 12 weeks.
The cause of a miscarriage is almost always a disposition disorder of the fetus, which occurred during the first divisions after the egg is fertilized. In most cases, a miscarriage involves a chromosomal abnormality in the foetus, which prevents its (healthy) growth. Your body will recognize this, and then reject the pregnancy. A miscarriage is not caused by stress, sex or exercise.
You can notice a miscarriage by vaginal bleeding (often in combination with menstrual-like abdominal pain or back pain), but often the ultrasound first shows that there is no longer a beating heart, before you experience symptoms such as blood loss. And so then you may also have noticed nothing at all.
A miscarriage happens differently for every woman. If bleeding has already started, in most women it takes a few days to 2 weeks until you go through the miscarriage completely. The In 3 out of 10 women, it takes more than 2 weeks for the miscarriage to get going or the miscarriage does not come on its own.